Premature Pubarche due to Exogenous Testosterone Gel or Intense Diaper Rash Prevention Cream Use: A Case Series

2019 ◽  
Vol 91 (6) ◽  
pp. 411-415 ◽  
Author(s):  
Carolina de Oliveira Ramos ◽  
Delanie Bulcão Macedo ◽  
Tania Aparecida Sartori Sanchez Bachega ◽  
Marilza Leal Nascimento ◽  
Guiomar Madureira ◽  
...  
Keyword(s):  
Pubertal Development ◽  
Laboratory Data ◽  
Case Series ◽  
Pubic Hair ◽  
Retrospective Case ◽  
Adrenal Androgen ◽  
Androgen Exposure ◽  
Case Series Study ◽  
Testosterone Gel ◽  
Premature Pubarche

Background/Aims: Premature pubarche is associated with conditions such as virilizing congenital adrenal hyperplasia, androgen-secreting tumors, and exogenous exposure to androgen products. We describe the clinical and hormonal features of a series of children who were referred to endocrine evaluation due to premature pubarche. Methods: This is a retrospective case series study of 14 children with premature pubarche and/or virilization. Five were unintentionally exposed to testosterone gel (parental use). Nine patients were intensely exposed to diaper rash prevention creams. Clinical and laboratory data were revised. Results: Moderate to severe virilization was detected in the 5 patients (2 boys and 3 girls) who were exposed to testosterone gel. These patients had pubic hair development associated with clitoromegaly (3/3), penile enlargement (2/2), and accelerated growth (5/5). Testosterone levels were elevated in 4/5 patients associated with normal prepubertal gonadotropin levels and adrenal androgen precursors. The 9 children who were intensely exposed to diaper rash prevention creams had mild pubarche (intermediate hair) without any other clinical manifestation of pubertal development. Three of them exhibited pubic hair thinning after cream withdrawal. Conclusion: Unintentional topical androgen exposure or the intense use of diaper rash prevention cream should be ruled out in children with precocious pubarche and/or virilization signs to avoid misdiagnosis and expendable investigation.

scholarly journals Clinical Characteristics, Treatments and Outcomes of 18 Lung Transplant Recipients with COVID-19

2021 ◽  
Vol 2 (2) ◽  
pp. 229-245
Author(s):  
René Hage ◽  
Carolin Steinack ◽  
Fiorenza Gautschi ◽  
Susan Pfister ◽  
Ilhan Inci ◽  
...  
Keyword(s):  
Lung Transplant ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Outcome Data ◽  
Transplant Recipients ◽  
Retrospective Case ◽  
Laboratory Findings ◽  
Case Series Study ◽  
Lung Transplant Recipients

We report clinical features, treatments and outcomes in 18 lung transplant recipients with laboratory confirmed SARS-CoV-2 infection. We performed a single center, retrospective case series study of lung transplant recipients, who tested positive for SARS-CoV-2 between 1 February 2020 and 1 March 2021. Clinical, laboratory and radiology findingswere obtained. Treatment regimens and patient outcome data were obtained by reviewing the electronic medical record. Mean age was 49.9 (22–68) years, and twelve (67%) patients were male. The most common symptoms were fever (n = 9, 50%), nausea/vomiting (n = 7, 39%), cough (n = 6, 33%), dyspnea (n = 6, 33%) and fatigue (n = 6, 33%). Headache was reported by five patients (28%). The most notable laboratory findings were elevated levels of C-reactive protein (CRP) and lactate dehydrogenase (LDH). Computed Tomography (CT) of the chest was performed in all hospitalized patients (n = 11, 7%), and showed ground-glass opacities (GGO) in 11 patients (100%), of whom nine (82%) had GGO combined with pulmonary consolidations. Six (33%) patients received remdesivir, five (28%) intravenous dexamethasone either alone or in combination with remdesivir, and 15 (83%) were treated with broad spectrum antibiotics including co-amoxicillin, tazobactam-piperacillin and meropenem. Four (22%) patients were transferred to the intensive care unit, two patients (11%) required invasive mechanical ventilation who could not be successfully extubated and died. Eighty-nine percent of our patients survived COVID-19 and were cured. Two patients with severe COVID-19 did not survive.

Electrophysiological effects and clinical utility of propafenone in children

2021 ◽  
pp. 1-5
Author(s):  
Manavotam Singh ◽  
Keore McKenzie ◽  
Mark L. Hudak ◽  
Anil K. Gehi ◽  
Sunita J. Ferns
Keyword(s):  
Case Series ◽  
Clinical Effectiveness ◽  
Retrospective Case ◽  
Cardiac Side Effects ◽  
Cardiac Depression ◽  
Case Series Study ◽  
Baseline Characteristics ◽  
Antiarrhythmic Medication ◽  
Electrophysiological Effects ◽  
Series Study

Abstract Aim: This retrospective case series study sought to describe the safety and clinical effectiveness of propafenone for the control of arrhythmias in children with and without CHD or cardiomyopathy. Methods: We reviewed baseline characteristics and subsequent outcomes in a group of 63 children treated with propafenone at 2 sites over a 15-year period Therapy was considered effective if no clinically apparent breakthrough episodes of arrhythmias were noted on the medication. Results: Sixty-three patients (29 males) were initiated on propafenone at a median age of 2.3 years. CHD or cardiomyopathy was noted in 21/63 (33%). There were no significant differences between demographics, clinical backgrounds, antiarrhythmic details, side effect profiles, and outcomes between children with normal hearts and children with CHD or cardiomyopathy. Cardiac depression at the initiation of propafenone was more common amongst children with CHD or cardiomyopathy compared to children with normal hearts. Systemic ventricular function was diminished in 15/63 patients (24%) prior to starting propafenone and improved in 8/15 (53%) of patients once better rhythm control was achieved. Other than one child in whom medication was stopped due to gastroesophageal reflux, no other child experienced significant systemic or cardiac side effects during treatment with propafenone. Propafenone achieved nearly equal success in controlling arrhythmias in both children with normal hearts and children with congenital heart disease or cardiomyopathy (90% versus 86%, p = 0.88). Conclusion: Propafenone is a safe and effective antiarrhythmic medication in children.

scholarly journals Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

2021 ◽  
Author(s):  
Ilkka Rauma ◽  
Tiina Mustonen ◽  
Juha Matti Seppä ◽  
Maritta Ukkonen ◽  
Marianne Männikkö ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Events ◽  
Case Series ◽  
Retrospective Case ◽  
Serious Adverse Events ◽  
Highly Active ◽  
Disease Modifying Therapy ◽  
Case Series Study ◽  
Multiple Sclerosis Patients

Abstract Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.

COVID-19 situation in Baden-Württemberg, Germany: Preliminary case series study during the first wave

2021 ◽  
Vol 1 (1) ◽  
pp. 6-11
Author(s):  
Dzmitry Katovich ◽  
Claudia Grun ◽  
Hanna Katovich ◽  
Bastian Hauer ◽  
Thomas Iber ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Symptoms ◽  
Fatal Outcome ◽  
Laboratory Data ◽  
Case Series ◽  
Severe Illness ◽  
Case Series Study ◽  
Regional Factors ◽  
Series Study

The present case series study presents the preliminary data of 347 of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) positively tested patients in the Mittelbaden hospital, Baden-Baden Bühl, Germany, during the period from March to June 2020. Among the 347 patients, 55% were males. The mean age-wise was 52.5±20.2 years in the overall cohort and 78.9±11.1 years in fatal outcome cases. A total of 120/347 patients (34.6%) required hospitalization, but only 36/347 (10.37%) cases required intensive care. The overall fatality rate was 6.6% (23/347), of which 12 patients were from the intensive care unit. The most frequent clinical symptoms observed were cough (62.5%), hyperthermia (47.8%), rhinorrhea (25.1%), sore throat (23.1%), dyspnea (22.8%), and headache (19.3%). Laboratory data analysis showed no specific findings, but severe laboratory disturbances could predict critical illness. A higher risk of severe illness or lethal outcome in elderly patients with several comorbidities was the most frequent. The fight against COVID-19 infection in Germany seems to be more successful during the first wave than in other countries. The improvement of the healthcare system against infectious outbreaks depends directly on the analysis of regional factors.

scholarly journals Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

2014 ◽  
Vol 86 (1) ◽  
pp. 15 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Hassan El-Tatawy ◽  
Ahmed Eissa ◽  
Abdel Hamid Elbahnasy ◽  
Mohamed Elbendary
Keyword(s):  
Case Series ◽  
Surgical Reconstruction ◽  
Urethral Injury ◽  
Penile Curvature ◽  
Retrospective Case ◽  
Penile Fracture ◽  
Case Series Study ◽  
Long Term Follow Up

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

scholarly journals Safety and efficacy of posterior iris claw intraocular lens fixation in aphakic patients

2018 ◽  
Vol 16 (2) ◽  
pp. 124-133
Author(s):  
Rosemary Tomy ◽  
Rajkumar Maheshwari ◽  
Ansa Parveen Kunhu Muhammed ◽  
Venkataramana Kalikivayi ◽  
Sajeev Cherian Jacob
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Applanation Tonometry ◽  
Long Term Results ◽  
Retrospective Case ◽  
Case Series Study ◽  
Wide Range

Purpose: To assess the indications and visual outcome of eyes undergoing posterior iris fixated intraocular lens (IFIOL) implantation for aphakia, to identify reasons for poor visual outcome, and report occurrence of complications. Methods: In this retrospective case series study, all cases of posterior IFIOL fixation performed over a 30-month period were identified retrospectively. Preoperative and postoperative evaluations comprised objective and subjective refraction, best corrected visual acuity (BCVA), slit lamp biomicroscopy, applanation tonometry, and dilated fundus examination. Results: Fifty-six eyes of 56 patients were analyzed. Mean age was 60.55 ± 17.2 years. The most common indication for IFIOL implantation was surgical aphakia following complicated cataract surgery (n = 33; 58.9%) followed by trauma (n = 10; 17.9%), dropped nucleus/IOL during primary surgery (n = 6; 10.7%), and subluxated/dislocated lens-induced glaucomas (n = 5; 8.9%). BCVA better than or equal to their preoperative BCVA was achieved in 96.43% patients. The surgical aphakia and paediatric/adolescent groups had the best visual results while the dropped nucleus/IOL group and subluxated lens-induced glaucoma groups fared poorly. On the long-term follow-up visit, the most common complication noted was pigment dusting on the corneal endothelium (65.7%). Conclusion: The long-term results suggest that posterior IFIOL implantation is a safe and effective method for correction of aphakia and can be used for a wide range of indications in eyes without adequate capsule support. It may be considered an easier and faster alternative with minimal manipulation to anterior segment structures in paediatric and post-traumatic aphakic eyes.

scholarly journals Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

2019 ◽  
Vol 5 (3) ◽  
pp. 69
Author(s):  
Divyanshu Goyal ◽  
S. L. Sharma ◽  
Laxmikant Meena ◽  
Ravindra Lamoria ◽  
Mahesh Bansal
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Case Series ◽  
Age Group ◽  
Forearm Fractures ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Fractures In Children ◽  
Case Series Study ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.</p><p class="abstract"><strong>Methods:</strong> We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year.  </p><p class="abstract"><strong>Results:</strong> In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.</p>

scholarly journals Clinical characteristics of a group of deaths with COVID-19 pneumonia in Wuhan, China: retrospective case series

2020 ◽  
Author(s):  
Tao Yao ◽  
Yan Gao ◽  
Qin Cui ◽  
Bo Peng ◽  
Yan Chen ◽  
...  
Keyword(s):  
Control Strategies ◽  
Antiviral Treatment ◽  
Invasive Mechanical Ventilation ◽  
Laboratory Data ◽  
Case Series ◽  
The Elderly ◽  
Retrospective Case ◽  
Initial Symptoms ◽  
Comorbid Diseases ◽  
Death Cases

Abstract Background: With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinial characteristics of deaths with COVID-19 pneumonia Methods: We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East hospital of Wuhan university Renmin hospital,between January 26, 2020, and February 28, 2020.Results: Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2; range, 34-97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7-14: range, 2-43 days), to death was 17days (IQR 14-21: range, 6-54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%) and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, and 54(65.1%) deaths received glucocorticoid therapy and 20(24.1%) patients received invasive mechanical ventilation.Conclusion: Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death was mostly 15-21 days after the onset of the disease. More care should be given to the elderly in the further prevention and control strategies of COVID-19.

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